G.E.N最新文献

The Helicobacter Pylori (Hp) has been related with the pathogenesis of the chronic gastritis, peptic ulcer, non ulcerous dyspepsia, and in the last studies it has been found in a great prevailing way in populations with gastric cancer risks. The purpose of this study was to determine the presence of Hp in asymptomatic adults, volunteers, healthy, by means of the utilization of two diacritic tests, a serologic test for the determination of antibody IgG anti Hp (Pyloriset) and the tests Urease (Clotest) relating it with the development of lesions. We studied 20 persons, from whom we took peripheral blood samples for the determination of Hp by means of the agglutination test of latex (Pyloriset) and a superior digestive endoscopy was carried out (SDE) with a gastric biopsy for the Tests of Ureasa (Clotest). In 15 adults (75%) the clotest was positive and in 13 persons (65%) the pyloriset was positive. In 9 persons (47%) the Hp was evidence by both methods. In 13 (65%) the SDE was pathological concluded and all were positive for the Hp. In 7 (35%) the SDE resulted normal. The presence of the antibody against the, Hp predicts alterations of the gastric mucosa like the development of the chronic gastritis, peptic ulcer and other pathologies. The Clotest is a simple tests, quick and sensible that allows us to apply immediate treatment. Our results suggest a high incidence of this bacteria in our workers, which justifies high prospective studies to determine same.

The prevalence of accessory spleens has been reported to be about 7.1% in infants. When these patients undergo splenectomy without removal of the accessory spleen, the latter develop hypertrophy later in life and can reach the size of a normal spleen, with clinical manifestations similar to the ones before surgery. We report the case, of fourteen-old boy, who had splenectomy 7 year ago, for refractory and recurrent thrombocytopenia, who had splenectomy at age 7 years because of persistent thrombocytopaenia, resistant to non-surgical treatment, and who was found by conventional ultrasound study, doppler duplex color and selective angiography to have a hypertrophied spleen with sings of portal thrombosis and portal hypertension.

We report 3 cases of gastric trichobezoar, recorded in the last 10 years in our Hospital. All the cases presented abdominal pain and tumor, as well as upper obstructive symptoms. The 3 cases were surgically treated with satisfactory evolution. The clinical has to consider this diagnosis taking into account the data summarized here. Surgery is a successful treatment for these cases. The literature on bezoars is reviewed.

In many works performed in different countries, including Cuba, the microorganism Helicobacter pylori (Hp) is involved in the etiopathogenesis and relapse of gastroduodenal ulcer (GDU). In a previous work, we saw that under treatment of Colloidal bismuth subcitrate (CBS) or Metronidazole (M) alone during 4 weeks, the percentage of Hp clearance obtained was very low. So, we decided to extend the treatment with a unique drug up to 6 weeks or to make a combination of drugs during 4 weeks. 114 patients with GDU endoscopic diagnosis and Hp positive by urease test antral biopsy were located in 5 schedules of treatment: 1) CBS 480 mg daily during 6 weeks; 2)M 1 g daily during 6 weeks; 3) CBS 480 mg daily plus M 750 mg daily during 4 weeks; 4) CBS 480 mg daily plus Amoxycillin (A) 1500 mg daily during 4 weeks and 5) M 750 mg daily plus Amoxycillin 1500 daily during 4 weeks. Endoscopy and urease test were repeated at the end of treatment. Healing of ulcer was obtained in 83.3%; 36.4%; 89.2%; 91.9% and 54.6% respectively. Hp clearance was reached in 55.6%; 27.3%; 67.6%; 70.3% and 27.3% respectively. So, the schedules of treatment less effective (concerning both healing and Hp clearance) were M during 6 weeks and M plus A during 4 weeks. It has been reported that Hp strains may become resistant to nitroimidazolics in the course of treatment and that this resistance could be diminished by the coadministration of CBS. We recommend in GDU-Hp positive a treatment with CBS during 6 weeks or the combination of CBS, which action is basically local, with an antibiotic such as M (no more than two weeks) or Amoxycillin during 4 weeks.

60 patients with Helicobacter pylori (Hp) infection and duodenal ulcer (DU) were randomized to received either: I) Two weeks of bismuth subcitrate, metronidazole and amoxicillin (TG) or II) Omeprazole for four weeks (OG). Endoscopy and antral biopsies were done at entry and four weeks after treatment, control endoscopy was performed 2-4-8 and 12 weeks after inclusion in the trial. Healing was similar in both groups at two four weeks. At twelve weeks DU recurred in OG 65% vs 13.36% in TG and Hp infection was present. Our results showed that Hp eradication healed DU in a similar rate than Omeprazole providing further evidence of a causal link between Hp infection and duodenal ulcer.

We have done a study in order two know the prevalence of anti-hepatitis C virus antibodies in polytransfused patients with hemophilia, leukemia and hemolytic anemia, along with 17 healthy donors, without previous history of transfusions. We analyzed samples from 10 hemophilic patients and 12 from leukemia, lymphoma and hemolytic anemia, all of them had received blood or blood products, at least six months before the study. Using a second generation ELISA, 4 positive sample (3 hemophilic and 1 lymphoma) were detected (10.26%), which represent a prevalence of 30% in the hemophilic group, in contrast with the prevalence detected in other countries. A very significant statistic association was demonstrated, between the positive ELISA, the amount of the transfused product (P < 0.0004) and the type of blood product used for transfusion (crioprecipited, P = 0.000, plasma P = 0.000).

Biliary Cystadenoma are rare benign neoplasms that occurs mainly in young women. Clinical features includes abdominal pain and biliary obstruction. The diagnosis is for clinical features and radiologic method, but require the pathological report. The treatment is surgical. We report a 30 years old woman, with biliary obstruction and radiological findings of a neoplasm located in the left hepatic duct, that was surgically removed. The pathological report was a biliary cystadenoma. We discuss the clinical radiological and pathological tindings.

We included 63 patients (p) with duodenal ulcer and Helicobacter pylori infection to be treated with Famotidine 40mg/day for six weeks. In the first ten days one group of 33p (TG) received Metronidazole 250mg plus Amoxicillin 500mg T.I.D and 30p (PG) placebo. Helicobacter pylori was eradicated in 62.5% of TG. Infection was always associated with ulcer recurrence. Healing was similar in both groups but recurrence was statistically significant after three month in PG and in the first year all Pg had relapsed. At 44 month only 25% of TG relapsed. The natural history of peptic ulcer disease was changed with Helicobacter pylori eradication.

The cholangiocarcinoma is a low-prevalence neoplasia, but represents a great medical challenge in its diagnosis and treatment because of its insidious clinical manifestations. Its cellular origin has been associated to other hepatic tumors, and to multiple congenital or acquired factors (infections, drugs and other diseases). The most frequent histological type is the adenocarcinoma and the most common localization is the choledochal duct; local metastases are frequently found in autopsies. The usual clinical findings are pruritus, weight loss, anorexia, jaundice and hepatomegaly. The immunohistochemical advances related to oncogenes (ras & C-erb B-1) and tumor markers (Epidermal Growth Factor and Integrin among others) allow to make differential diagnosis with other hepatic cancers and will provide valuable information about its cell biology. The initial approach to patients with this disease is made by ultrasound (US), which can be associate to Doppler; Computed Axial Tomography and Nuclear Magnetic Resonance have similar sensitivity and specificity, so they are preferred to US in the elderly with history of weight loss. It's better to perform Percutaneous Transhepatic Cholangiography than Endoscopic Retrogrado Pancreatocholangiography when its possible because the first permits a comprehensive visualization of the biliary tree. The treatment includes resection and endoprosthesis placement. The combination of surgery, Chemotherapy and Radiotherapy allows to achieve the best survival rates, and opens a door to new strategies related to this malignancy.